Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States
By Christopher J. L. Murray, Sandeep C. Kulkarni, C. Michaud, Niels Tomijima, M. Bulzacchelli, Terrell J. Iandiorio, M. Ezzati. PLoS Medicine, 2006
780 citations recorded by the source corpus.
Background The gap between the highest and lowest life expectancies for race-county combinations in the United States is over 35 y. We divided the race-county combinations of the US population into eight distinct groups, referred to as the “eight Americas,” to explore the causes of the disparities that can inform specific public health intervention policies and programs. Methods and Findings The eight Americas were defined based on race, location of the county of residence, population density, race-specific county-level per capita income, and cumulative homicide rate. Data sources for population and mortality figures were the Bureau of the Census and the National Center for Health Statistics. We estimated life expectancy, the risk of mortality from specific diseases, health insurance, and health-care utilization for the eight Americas. The life expectancy gap between the 3.4 million high-risk urban black males and the 5.6 million Asian females was 20.7 y in 2001. Within the sexes, the life expectancy gap between the best-off and the worst-off groups was 15.4 y for males (Asians versus high-risk urban blacks) and 12.8 y for females (Asians versus low-income southern rural blacks). Mortality disparities among the eight Americas were largest for young (15–44 y) and middle-aged (45–59 y) adults, especially for men. The disparities were caused primarily by a number of chronic diseases and injuries with well-established risk factors. Between 1982 and 2001, the ordering of life expectancy among the eight Americas and the absolute difference between the advantaged and disadvantaged groups remained largely unchanged. Self-reported health plan coverage was lowest for western Native Americans and low-income southern rural blacks. Crude self-reported health-care utilization, however, was slightly higher for the more disadvantaged populations. Conclusions Disparities in mortality across the eight Americas, each consisting of millions or tens of millions of Americans, are enormous by all international standards. The observed disparities in life expectancy cannot be explained by race, income, or basic health-care access and utilization alone. Because policies aimed at reducing fundamental socioeconomic inequalities are currently practically absent in the US, health disparities will have to be at least partly addressed through public health strategies that reduce risk factors for chronic diseases and injuries.
Subfields: Clinical Psychology, General Health Professions, Health
View Paper: https://www.semanticscholar.org/paper/ca45fa69a94a731297eab3c3de1509e924bea3f5
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Citations in the corpus
- The Reversal of Fortunes: Trends in County Mortality and Cross-County Mortality Disparities in the United States (2008, neutral): “There were two reasons for forming merged county units: (1) to avoid unstable death rates, smaller counties were merged with adjacent counties to form units with a total population of at least 10,000 males and 10,000 females in 1990 [14]; and (2) to account for changes in county definitions and line”
- Health Disparities due to Diminished Return among Black Americans: Public Policy Solutions (2018, background): “112 C© 2018 The Society for the Psychological Study of Social Issues of childhood chronic disease (Miller, 2000), and higher mortality and morbidity of Blacks later in life (McClellan et al., 2006; Murray et al., 2006).”
- Race and ethnicity, gender, and age on perceived threats and fear of COVID-19: Evidence from two national data sources (2020, neutral): “, 2011), and higher rates of mortality (Murray et al., 2006).”